ABSTRACT
OBJECTIVE: To examine the relationship between abdominal obesity, as measured by waist-to-hip ratio (WHR) and high-density lipoprotein cholesterol (HDL-C) level within the context of age, body fatness, exercise, saturated fat intake, and other plasma lipids. DESIGN/SUBJECTS: Subjects were premenopausal, white, non-Hispanic women from the third National Health and Nutrition Examination Survey. Smokers, heavy drinkers, and women who took lipid-altering drugs were excluded. Of 1,188 subjects who met the inclusion criteria, complete data were available for 435 women. STATISTICAL ANALYSES: Means were calculated using all subjects for each variable, then F-protected t tests and linear contrasts were performed to test differences in means between subgroups. A P < .05 was considered significant. RESULTS: Age was not significantly associated with HDL-C level. Comparisons of HDL-C by WHR, percentage body fat (%BF), and exercise level revealed that HDL-C level was significantly lower at the higher levels of WHR and %BF and higher at the highest levels of exercise. Higher levels of HDL-C were generally accompanied by lower levels of triacylglycerol. When HDL-C was compared by exercise level within each WHR tertile and %BF tertile, the association of exercise with HDL-C diminished. Saturated fat intake was not associated with HDL-C. CONCLUSIONS/APPLICATIONS: Increased exercise is associated with a lower WHR and subsequently a higher HDL-C level. This association between WHR and HDL-C appears to be mediated through %BF. Women exercisers with the highest WHR had consistently more favorable plasma lipid profiles and lower mean body mass index and %BF than nonexercisers. Thus, for women who exhibit abdominal obesity, exercise mitigates the association of WHR with HDL-C level. Vigorous exercise in the premenopausal years may promote a more favorable lipid profile, even in the presence of increased body fat and abdominal girth.
